1. A Guide to Diabetes in the School Setting © McKinney Independent School District

2. IDEA - Public Law 94-142 Student Rights Free and appropriate public education. Least restrictive environment. Eligible students receive services to meet their individual needs (IEP). Diabetes classified as “Other Health Impairment”.

3. Rehabilitation Act - Section 504 Protects persons with disabilities from being excluded from participation in any program or activity receiving federal funding. A 504 plan may be written to specifically state the accommodations necessary to meet the student’s needs at school.

4. HB 984 Schools are responsible for developing Individual Health Plan and training appropriate school personnel to assist the diabetic student in their needs at school and school activities.

5. What is Diabetes? Diabetes is a serious, chronic disease that impairs the way the body uses food. Insulin, a hormone produced by the pancreas, helps the body convert food into energy. In diabetes, the pancreas does not make insulin or the body cannot use the insulin properly.

6. What is Diabetes? This can cause the blood sugar level to be too high or too low. Diabetes cannot be cured, only managed. Diabetics must carefully balance food, medications and activity levels to keep the blood sugar level as close to normal as possible.

7. Types of Diabetes Type I Pancreas does not produce insulin Must receive insulin through injections or a pump Most common type afflicting school-age children Type II Insulin is not used properly in the body May be able to control the disease with diet and exercise May require oral medications and/or injections Obesity is a high risk factor

8. The student may have to visit the nurse at scheduled times for blood testing and/or insulin injections, as well as urine testing. It is the responsibility of the teacher, student, and nurse to ensure testing and/or medications are administered on time. Special arrangements should be made in the event of field trips or class parties. Diabetic Management at School

9. It may be necessary for a diabetic student to eat a snack in the classroom to maintain adequate blood sugar levels. Depending on maturity, blood sugar testing may be performed in the classroom. Insulin will be administered in the clinic. Some students have insulin pumps which automatically administer calculated amounts of insulin.

10. Diabetic Management at School The student may need special scheduling for lunch. The student may require quick acting sugar to be available at all times. The student may require free access to water; may carry a water bottle. The student will require free access to the restroom.

11. Hypoglycemia (Low Blood Sugar) Caused when the body gets too much insulin, too little food, a delayed meal, or more exercise than usual Symptoms include: Light-headedness Irritability Confusion Inability to follow directions Sleeping in class Headache Hunger Shakiness/Fainting

12. Hyperglycemia (High Blood Sugar) Occurs when the body gets too little insulin, too much food, or too little exercise May also be caused by stress or an illness Symptoms include: Excessive thirst Frequent urination/trips to the restroom Blurry vision Fast heart rate, rapid breathing Nausea/Vomiting

13. Always allow a student with symptoms to go to the nurse immediately. Never allow a student with symptoms to go to the clinic by him/herself. Only staff members who are trained in diabetes management should treat a symptomatic student. Hypoglycemia will be treated with glucose tablets/gel, juice, snacks, or soda according to the students individual plan. Hyperglycemia will be treated with insulin administered by a nurse or trained unlicensed diabetic care assistant per IHP. Treatment of Symptoms

14. Hypoglycemia and hyperglycemia can both be potentially life-threatening and must be treated immediately. 9-1-1 and trained staff members should be contacted immediately. Hypoglycemia may cause unconsciousness or seizures and may be treated with Glucagon administered by the nurse or trained unlicensed diabetic care assistant. Emergency Care

15. Your student with Diabetes Will have an individualized health care plan, specific to their Diabetes management. Will have specific instructions for emergency care management. Will have specific equipment/supplies/snacks.

16. What YOU need to do Check with your school nurse to obtain specific information about students with Diabetes under your instruction/supervision. Attend training provided by your school nurse about each individual diabetic student in your class. Read the accompanying attached handout “A Guide to Diabetes in the School”.

17. What YOU need to do Print and keep the attached handout as a reference for yourself and your substitutes. Please ask for any clarification about Diabetes and the management of a diabetic student from your school nurse. Thank you for your participation in learning about the care of students with diabetes.

18. Gloria Canham RN Erin Jones RN Sharon Simpson RN Sandra Wheeler RN Copyright used with permission from Richardson ISD Health Services